Impact of Adenotonsillectomy on Quality of Life in Children With Obstructive Sleep Disorders | Otolaryngology | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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Original Article
May 2002

Impact of Adenotonsillectomy on Quality of Life in Children With Obstructive Sleep Disorders

Author Affiliations

From the Division of Pediatric Otolaryngology, The Children's Hospital of New York, NY Presbyterian Hospital, Columbia University, New York (Drs de Serres, Haddad, and Tampakopoulou); the Department of Otolaryngology–Head and Neck Surgery, Children's Hospital of the King's Daughter, Eastern Virginia Medical School, Norfolk (Dr Derkay); the Division of Pediatric Otolaryngology, Children's Hospital and Regional Medical Center, Department of Otolaryngology–Head and Neck Surgery, University of Washington, Seattle (Drs Sie, Manning, and Inglis); the Division of Pediatric Otolaryngology, Children's Hospital of Dallas, Dallas, Tex (Dr Biavati); the Division of Pediatric Otolaryngology, New York Weill Cornell Medical Center, NY Presbyterian Hospital, Cornell University, New York (Dr Jones); the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Md (Dr Tunkel); and the Department of Surgery, NY Presbyterian Hospital, Columbia University, New York (Mr Weinberg).

Arch Otolaryngol Head Neck Surg. 2002;128(5):489-496. doi:10.1001/archotol.128.5.489
Abstract

Objectives  To determine the impact of adenotonsillectomy on quality of life (QOL) in children with obstructive sleep disorders (OSDs) before and after surgery.

Design  Prospective, observational, before-and-after trial.

Setting  Seven tertiary pediatric otolaryngology practices.

Patients  Convenience sample of 101 children (mean age, 6.2 years) with adenotonsillar hypertrophy and OSD scheduled for adenotonsillectomy.

Intervention  Adenotonsillectomy was performed in children for OSDs. Quality of life was assessed using the Obstructive Sleep Disorders–6 survey, a validated instrument for detecting QOL change in children with OSDs. Surveys were completed at the initial office visit (visit 1), the day of surgery (visit 2), and at the postoperative office visit (visit 3). Physical characteristics were assessed using tonsillar and orocraniofacial scales (visit 1). Satisfaction with health care decisions was assessed using the Satisfaction With Decision and Satisfaction With Office Visit scales (visit 1).

Main Outcome Measures  Short-term changes in QOL before (visits 1 and 2) and after (visits 2 and 3) surgery.

Results  Changes in QOL before surgery were trivial or small, and smaller than changes after surgery (mean change score, 0.18 vs 2.3; P<.001). Large, moderate, and small improvements in QOL were seen in 74.5%, 6.1%, and 7.1% of children, respectively. Sleep disturbance, caregiver concern, and physical suffering were the most improved domains, although significant changes also occurred for speech and swallowing problems, emotional disturbance, and activity limitations. Five percent of children had poorer QOL after surgery, but no predictive factors were identified.

Conclusion  Adenotonsillectomy produces large improvements in at least short-term QOL in most children with OSDs.

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